Individual provider Active NPI

Gary H Chandler, CRNA

  • Certified Registered Nurse Anesthetist
  • New Albany, MS
National Provider Identifier
1386732154
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R743486 Issued in MS
Practice address
200 State Highway 30 W
New Albany, MS 38652-3112
Phone
(662) 538-2370
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R743486 MS Primary

Addresses

Primary practice location

200 State Highway 30 W
New Albany, MS 38652-3112

Mailing address

4810 Stonebridge CV
Tupelo, MS 38801-9499
Phone (662) 841-2858

Other identifiers 1

IdentifierTypeStateIssuer
00125903MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205000838 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406749159 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willow Anesthesia Services LLCGroup PAC ID 9234279183, 52 clinicians

Practice addresses (Care Compare)

303 Medical Ctr Dr
Batesville, MS 38606-8608
Phone (662) 553-5611

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

Hospital & facility affiliations

  • University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R743486MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jan 19, 2014 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi-University of Mississippi Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jan 19, 2014 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC CurrentSince Oct 1, 2019 Accepting new patients
Willow Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 26, 2019 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms LLC CurrentSince Oct 1, 2019 Accepting new patients
State of Mississippi-University of Mississippi Medical Center Nurse Anesthetist, Certified Registered CurrentSince Sep 20, 2019 Accepting new patients
Boa Vida Hospital of Aberdeen, Ms, LLC Past Accepting new patients
Tupelo Anesthesia Group PA Past Accepting new patients
Baptist Memorial Hospital - Golden Triangle Inc. Past Accepting new patients

Locations

400 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-2455

960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386732154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 STONEBRIDGE CV",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388019499",
            "telephone_number": "662-841-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STATE HIGHWAY 30 W",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523112",
            "telephone_number": "662-538-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "GARY",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R743486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125903",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.